BEING AN NHS CHIEF EXECUTIVE…

In these early weeks after publication, it is nice to talk to a few reviewers about the book. Here are some of the questions I’ve been answering.

Why did you write it?

Because I felt I had something to say, about our attitudes to mental illness, and about suicide and abuse. I wanted to speak directly to those who devote their lives to public service. I also wrote it for a bit of catharsis. I haven’t had a work dream since I finished it, so that plan seems to be working – so far…

Is there still stigma about mental illness?

You bet there is. It will take more than a few people in the public eye talking about their own experiences to rid us of that terrible stigma. It manifests itself in the way people who are mentally ill are portrayed in the media, although have seen some progress. But more in how society (including government, who are elected by the people and in effect do their bidding) treats people who experience mental illness. There is unfair discrimination in access to decent housing, welfare benefits, support in finding meaningful employment, and to timely, compassionate, effective health care. Here in the UK, people with the most severe forms of mental illness die on average 20 years earlier than the general population. That should be a national scandal. The fact that it isn’t seems to me to be cast-iron evidence of the stigma that still exists.

Why did you decide to come out about your own experiences of anxiety and depression, having kept quiet for 58 years?

Until I was in my early forties, I wouldn’t have described my experiences as that. My self-stigma was so great that I viewed my inability at times to face the world, simply as personal weakness or flaws in my character. And then, once I began to accept my experiences for what they really were, I felt that talking about them would be self-indulgent, given the good luck I seem to have had with my family, friends, education, home and job.

This is something that people like me must always look out for. When I had my last major depression and was huddled in the dark wanting to be dead, I didn’t have to worry about being made homeless, having no money and getting no treatment or support. So I should watch my privilege.

What is your biggest regret?

Probably not dealing with all the above sooner, so that I could have used my understanding to help tackle the stigma that mental health services experienced throughout my 13 years of being in a position of influence. In fact, cuts to services are increasing as I write this, despite all the government rhetoric.

As well as being cruel, this is a false economy. Most mental illnesses start when we are young. If young people get the right advice and treatment straight away, the chances are they will be able to resume their education and personal lives fairly quickly, growing up to become full participants and contributors to society. It doesn’t mean they will necessarily be cured, but it does mean that the disabling impacts of mental illness will be avoided or kept to a minimum. Imagine if we said to people with cancer, look, your tumour isn’t causing you enough problems yet. Go away and manage it yourself and only come back when you are dangerously ill. There would be an outcry.

But just having regrets is wasted energy. So I’m doing what I can, writing blogs like this, talking about it to anyone who will listen, and using the book as an introduction to a having a different sort of conversation.

What are you writing now?

A novel set in a choir school. It is half done but I am trying to concentrate on it properly now. When writing fiction, you need to let the creative juices run, which for me means starting to write as soon as I wake up. Some days I am in still in my PJs at 3 o’clock in the afternoon. At least that’s my excuse!